Dr. Sarah Buckley: Epidurals – Risks and Benefits

In Babymoon’s 5-week Lamaze series, we discuss at length the six “Healthy Birth Practices” that have been linked to better outcomes for moms and babies. One of these healthy birth practices is to avoid unnecessary interventions.

But how does one determine when an intervention is necessary or unnecessary? We recommend using your BRAIN – examining the Benefits, Risks, and Alternatives to an intervention, and then asking yourself what your Intuition says and what happens if we do Nothing (right Now).

In the first of series of her blogs on her web site, Sarah Buckley begins to examine the benefits and risks of an epidural and shares some of the research surrounding this common intervention. Buckley, a physician who also authored Gentle Birth, Gentle Mothering: A Doctor’s Guide to Natural Childbirth and Gentle Early Parenting Choices, says:

“Obviously, the main benefit of an epidural is the very effective pain relief that most women experience. Because of this effective analgesia, epidurals also reduce stress, and stress hormones, in labour. This can be beneficial when women are experiencing very high levels of stress and pain, which can slow labour progress.”

To understand some of the risks or side effects of an epidural, we first must understand oxytocin. As we discuss in our Lamaze series, the hormone oxytocin – also known as the “love hormone” – is a key player in the process of labor and birth.

“Receptor cells that allow your body to respond to oxytocin increase gradually in pregnancy and then increase a lot during labor. Oxytocin stimulates powerful contractions that help to thin and open (dilate) the cervix, move the baby down and out of the birth canal, push out the placenta, and limit bleeding at the site of the placenta.”

Buckley explains that within the oxytocin “positive feedback cycle” (as illustrated in the diagram), uterine sensations lead to oxytocin release which contributes to stronger contractions, more sensations, and more oxytocin. The cycle continues and helps baby to be born quickly and easily. Oxytocin also activates reward and pleasure centers in the brain.

When epidural analgesia is introduced into the equation during labor, there are no longer sensations to trigger oxytocin release, and therefore levels will decline.

Buckely will explore the consequences of a lack of oxytocin in Part 2 of her series, coming soon.